Can tight hamstrings cause back pain?

Hinge Health member’s question: 

"How do tight hamstrings affect my back pain, and what can I do to feel better?” 

Hinge Health physical therapist Melia Lewis’s answer:

Tight hamstrings and lower back pain are often connected, but not everyone with tight hamstrings will experience back discomfort. As a physical therapist, I see firsthand how tightness or imbalances in one muscle group can affect pain and mobility in other areas of the body. But taking a whole-body approach to movement can help you address your pain.

How tight hamstrings affect your lower back 

Your hamstrings are muscles that run along the back of your thighs and attach to the back of your hip bones. When they become tight, they can pull your pelvis backward into what we call a posterior pelvic tilt. This flattens the natural curve in your lower back, which reduces your back mobility. Your lower back muscles may compensate by tightening up, and over time, this imbalance can lead to stiffness, discomfort, and even pain.

The good news is that this isn’t permanent. Regular stretching and mobility exercises for your hamstrings, hips, and lower back can help restore balance and improve movement.

Who gets back pain from tight hamstrings?

There are two groups of people who tend to be most affected by tight hamstrings. 

• Sedentary individuals. People who sit for long periods — such as those with desk jobs — are more prone to tight hamstrings. Sitting keeps your hamstrings in a shortened position, which reduces flexibility and mobility.

• Highly active individuals. On the other end of the spectrum, people who are on their feet all day, such as warehouse workers or long-distance runners, can also experience tight hamstrings. The repetitive nature of their movements can lead to muscle imbalances and strain on the lower back.

Additionally, people with a history of abdominal surgery (such as C-sections), hip injuries, or knee injuries may be more prone to back pain due to muscle imbalances.

How to relieve back pain from tight hamstrings

Movement is one of the best ways to prevent and manage back pain related to tight hamstrings. If you spend most of your day sitting, try to change positions every 45-60 minutes — stand up, stretch, take a short walk, or shift how you’re sitting. On the other hand, if you’re constantly on your feet or doing repetitive motions, it’s just as important to give your body a break. Taking time to rest, stretch, or move in different ways can help balance out strain on your muscles. Our bodies are designed to move in all directions, and when we vary our movement patterns, we help prevent stiffness and reduce stress on the lower back. 

Incorporating targeted exercises, especially hamstring stretches for lower back relief, can also be incredibly helpful. I especially like:

• Standing hamstring stretch. This is a great way to reduce tightness in your hamstrings and you can do it just about anywhere. 

• Cat cow. This helps you flex and extend your lower back so you can improve mobility there. 

• Bird dog. This helps strengthen your core, which supports and stabilizes your lower back to reduce pain.  

• Seated marches. These strengthen your hip flexors, which helps counteract the effects of tight hamstrings and eases strain on your lower back.

My main takeaway 

Tight hamstrings don’t always cause back pain, but they can reduce your mobility, changing how your lower back moves and feels. The best way to manage this is through movement — changing positions often, stretching, and strengthening key muscles can all help. Whether you mostly sit or are on your feet all day, vary your movements to keep your back feeling its best.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References 

1. Gou, Y., Lei, H., Chen, X., & Wang, X. (2024). The effects of hamstring stretching exercises on pain intensity and function in low back pain patients: A systematic review with meta-analysis of randomized controlled trials. SAGE Open Medicine, 12. doi:10.1177/20503121241252251

2. Jandre Reis, F. J., & Macedo, A. R. (2015). Influence of Hamstring Tightness in Pelvic, Lumbar and Trunk Range of Motion in Low Back Pain and Asymptomatic Volunteers during Forward Bending. Asian Spine Journal, 9(4), 535. doi:10.4184/asj.2015.9.4.535

3. Park, D., & Jung, S. (2020). Effects of hamstring self-stretches on pelvic mobility in persons with low back pain. Physical Therapy Rehabilitation Science, 9(3), 140–148. doi:10.14474/ptrs.2020.9.3.140